Douglas Lee Park, DDS

Pediatric Dentistry · Gresham, OR

Individual Active NPI

NPI number 1366521122

Practice location

1201 SE 223rd Ave
Suite 240
Gresham, OR 97030
Phone
(503) 666-9800
Fax
(503) 666-6787

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NPI record

NPI
1366521122
Entity type
Individual (Type 1)
Enumeration date
November 3, 2006
Last updated
July 8, 2007
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Pediatric Dentistry Primary 1223P0221X D6620 OR

Mailing address

34116 SE Carpenter Ln
Gresham, OR 97080
Phone
(503) 663-5162

About Dr. Park

Douglas Lee Park, DDS is a healthcare provider registered in the NPI registry with the primary taxonomy Pediatric Dentistry (code 1223P0221X). The practice location is 1201 SE 223rd Ave, Suite 240, Gresham, OR 97030. The NPI number 1366521122 was assigned on November 3, 2006 and the record was last updated on July 8, 2007.

Dr. Park lists a license in the registry: #D6620 (OR) for Pediatric Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Douglas Lee Park, DDS?

The NPI number is 1366521122.

What is the phone number of Dr. Park?

The phone number listed for the practice location is (503) 666-9800.

Where is Dr. Park located?

1201 SE 223rd Ave, Suite 240, Gresham, OR 97030.

What is the taxonomy code for Dr. Park?

The primary taxonomy code is 1223P0221X – Pediatric Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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